Fiona Fox

Doing Synchronous Online Focus Groups With Young People Methodological Reflections

Although online focus groups are emerging as a worthwhile methodological approach for qualitative researchers, reporting has been constrained in several ways. The majority of studies report asynchronous groups, whereas others employ synchronous exchanges, the efficacy of which with young people has seldom been explored. Considering the popularity of the Internet as a communication tool for young people, this missed opportunity is surprising. Based on a series of synchronous online focus groups with young people, the authors explore why this approach might be an effective way of engaging young people with appearance-related concerns in research. In this article, they discuss the process of hosting and moderating synchronous online focus groups, highlighting some of the ethical, pragmatic, and personal challenges that might face researchers using this method. Through a reflexive approach, they intend to inform and encourage qualitative researchers to consider alternative ways of engaging young people in research.

Experiencing “The Other Side”: A Study of Empathy and Empowerment in General Practitioners Who Have Been Patients

Work-related pressures and susceptibility to health problems mean that many general practitioners (GPs) will, at some stage, experience the role of patient. However qualitative evidence about their experiences of illness and patienthood is sparse. Our study offers an interpretative perspective on GPs’ experiences of illness and the influence that this has had on their practice. Seventeen GPs who had experienced significant illness took part in semistructured interviews. Data were analyzed using interpretative phenomenological analysis (IPA). The findings highlight the relationship between empathy and empowerment and explore the role of self-disclosure of GP status by GPs in consultations. We make suggestions as to how empathy in doctor—patient relationships can be developed through consideration of power and status as well as through interaction with patients from similar backgrounds. Future research should focus on more specific ways to integrate these ideas into medical training.

Lost to the NHS: a mixed methods study of why GPs leave practice early in England.

Background The loss of GPs in the early stages of their careers is contributing to the GP workforce crisis. Recruitment in the UK remains below the numbers needed to support the demand for GP care. Aim To explore the reasons why GPs leave general practice early. Design and setting A mixed methods study using online survey data triangulated with qualitative interviews. Method Participants were GPs aged <50 years who had left the English Medical Performers List in the last 5 years (2009–2014). A total of 143 early GP leavers participated in an online survey, of which 21 took part in recorded telephone interviews. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis techniques. Results Reasons for leaving were cumulative and multifactorial. Organisational changes to the NHS have led to an increase in administrative tasks and overall workload that is perceived by GP participants to have fundamentally changed the doctor–patient relationship. Lack of time with patients has compromised the ability to practise more patient-centred care, and, with it, GPs’ sense of professional autonomy and values, resulting in diminished job satisfaction. In this context, the additional pressures of increased patient demand and the negative media portrayal left many feeling unsupported and vulnerable to burnout and ill health, and, ultimately, to the decision to leave general practice. Conclusion To improve retention of young GPs, the pace of administrative change needs to be minimised and the time spent by GPs on work that is not face-to-face patient care reduced.

Exploring analytical trustworthiness and the process of reaching consensus in interpretative phenomenological analysis:lost in transcription

Typically authors explain how they conduct interpretative phenomenological analysis (IPA), but fail to explain how they ensured that their analytical process was trustworthy. For example, a minority mention that they ‘reached consensus’ after having engaged in a shared analysis of the data, but do not explain how they did so. In this article, we report on our experience of engaging in a shared analysis and aim to stimulate discussion about the process of ensuring the trustworthiness of one’s data when employing IPA. Our key recommendation is that all researchers involved in analysis should listen to the audio recordings; failure to do so increases the potential for researchers to superimpose their own presuppositions or interpretative bias onto the data. We also suggest that audio recordings should be kept for a longer duration in case secondary analysis is required. We finish our article with a series of tips developed from our experience of shared analysis.

Junior doctors' experiences of personal illness: a qualitative study.

Medical Education 2011: 45: 1251–1261

Junior doctors' experiences of personal illness

Medical Education 2011: 45: 1251–1261

GPs role identifying young people who self-harm: a mixed methods study

Background: Self-harm is common among young people and is evident in increasingly younger age groups. Many young people who self-harm do visit their GP but do not access specialist support. GP’s can find it challenging to raise and discuss this sensitive subject with young people during short consultations. Objective: To explore GP’s capabilities, motivations and opportunities for discussing self-harm and to identify barriers to and enablers for proactively discussing self-harm with young people. Design and setting: An exploratory, mixed methods study was designed comprising an online survey and a qualitative interview study with GPs in the South West of England. Methods: An online survey was completed by 28 GPs. Ten GPs took part by telephone, in semi-structured interviews. Quantitative data was analysed using descriptive statistical techniques and thematic analysis was used to analyse the qualitative data. Findings from the quantitative and qualitative analysis are synthesized to illustrate GPs’ skills, knowledge and perceptions about young people who self-harm. Results: Experienced GPs may underestimate the prevalence of self-harm in young people, particularly in the 11–14 age range. While consultations with young people and their carers can be challenging, GPs acknowledge that it is their role to provide support for young people who self-harm. GPs would welcome training for themselves and other practice staff in talking to young people and practical information about self-harm. Conclusion: All primary care staff who provide frontline support to young people should receive education and practical training in talking about self-harm.

“It’s crucial they’re treated as patients”: ethical guidance and empirical evidence regarding treating doctor–patients

Ethical guidance from the British Medical Association (BMA) about treating doctor–patients is compared and contrasted with evidence from a qualitative study of general practitioners (GPs) who have been patients. Semistructured interviews were conducted with 17 GPs who had experienced a significant illness. Their experiences were discussed and issues about both being and treating doctor–patients were revealed. Interpretative phenomenological analysis was used to evaluate the data. In this article data extracts are used to illustrate and discuss three key points that summarise the BMA ethical guidance, in order to develop a picture of how far experiences map onto guidance. The data illustrate and extend the complexities of the issues outlined by the BMA document. In particular, differences between experienced GPs and those who have recently completed their training are identified. This analysis will be useful for medical professionals both when they themselves are unwell and when they treat doctor–patients. It will also inform recommendations for professionals who educate medical students or trainees.

“It was like walking without knowing where I was going”: A Qualitative Study of Autism in a UK Somali Migrant Community

Increasing recognition of autism in Somali migrant communities means that appropriate support services are needed. Attitudes to autism and barriers related to help-seeking in these communities are poorly understood. We aimed to assess what families affected by autism need, and how health, education and social care services can support them. In partnership with the local Somali community the research team conducted 15 in-depth interviews with parents affected by autism. Two themes are reported; ‘Perceptions of Autism’ and ‘Navigating the System’. Our research shows the importance of understanding cultural views of autism and the need to raise awareness, reduce stigma and provide support to encourage families not to delay seeking help for their children.

Alcohol screening and brief interventions for adults and young people in health and community-based settings: a qualitative systematic literature review

BackgroundSystematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings. Fewer reviews have explored this through examination of qualitative literature and fewer still focus on interventions with younger people.MethodsThis review aims to examine qualitative literature on the facilitators and barriers to implementation of ASBI both for adults and young people in healthcare and community-based settings. Searches using electronic data bases (Medline on Ovid SP, PsychInfo, CINAHL, Web of Science, and EMBASE), Google Scholar and citation searching were conducted, before analysis.ResultsFrom a total of 239 papers searched and screened, 15 were included in the final review; these were selected based on richness of content and relevance to the review question. Implementation of ASBI is facilitated by increasing knowledge and skills with ongoing follow-up support, and clarity of the intervention. Barriers to implementation include attitudes towards alcohol use, lack of structural and organisational support, unclear role definition as to responsibility in addressing alcohol use, fears of damaging professional/ patient relationships, and competition with other pressing healthcare needs.ConclusionsThere remain significant barriers to implementation of ASBI among health and community-based professionals. Improving the way health service institutions respond to and co-ordinate alcohol services, including who is most appropriate to address alcohol use, would assist in better implementation of ASBI. Finally, a dearth of qualitative studies looking at alcohol intervention and implementation among young people was noted and suggests a need for further qualitative research.